Department of Oral Diagnostic Services, Howard University College of Dentistry, Washington, DC 20059, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Apr;115(4):e26-30. doi: 10.1016/j.oooo.2012.07.487. Epub 2012 Oct 24.
The authors present a case demonstrating the success of topical tacrolimus (TAC) therapy with custom trays in the treatment of oral chronic graft-versus-host disease (cGVHD). The 41-year-old male patient initially responded to topical steroid therapy (clobetasol propionate 0.05% ointment) applied both topically and with flexible carrier trays, but later became refractory to this potent topical agent. Topical TAC therapy with flexible carrier trays and systemic prednisone therapy was initiated.
The patient responded favorably with the change to topical TAC therapy with custom trays (and oral prednisone). His oral cGVHD lesions resolved within a period of 4 weeks. The improvement has remained stable at 14 months of follow-up.
This is the first case reported with regard to the successful resolution of steroid recalcitrant cGVHD successfully treated with topical TAC with custom trays.
作者报告了一例病例，展示了使用定制托盘局部他克莫司（TAC）治疗口腔慢性移植物抗宿主病（cGVHD）的成功。这名 41 岁的男性患者最初对局部皮质类固醇治疗（丙酸氯倍他索 0.05%软膏）有反应，无论是局部应用还是使用弹性载体托盘均有反应，但后来对这种强效局部药物产生了耐药性。随后开始使用弹性载体托盘局部 TAC 治疗和全身泼尼松治疗。
改用局部 TAC 治疗和定制托盘（以及口服泼尼松）后，患者反应良好。他的口腔 cGVHD 病变在 4 周内得到缓解。在随访 14 个月时，病情仍保持稳定。
这是首例报告的成功解决皮质类固醇难治性 cGVHD 的病例，该病例成功地使用定制托盘局部 TAC 治疗。
